What You Should Know: – Unite Us, the tech company building coordinated care networks nationwide announced a significant expansion to its partnership with Nebraska Health Information Initiative (NEHII), a health information exchange, to six additional states. – This growing partnership aims to break down existing… Read More »Unite Us Expands Social Determinants of Health Platform to 6 States
Can’t see the audio player? Click here to listen on SoundCloud. For the first time in a long time, there is some good news about the coronavirus pandemic: Although cases continue to climb, fewer people seem to be dying. And there are fewer cases than expected… Read More »KHN’s ‘What the Health?’: A Little Good News and Some Bad on COVID-19
As the 2020 Election Day approaches, many candidates continue to focus on health care issues, including on the public health and economic response to COVID-19, the future of the Affordable Care Act, health care costs and abortion. To help reporters understand and cover these issues,… Read More »Health Policy Resources for Covering the 2020 Elections
After Nebraskans cast their vote for Medicaid expansion in 2018, the state is finally expanding coverage to more residents. As part of the state’s rollout, it split its expanded Medicaid plans into two tiers, with work and other requirements to access dental and vision coverage.
A Massachusetts-based home health company and its owners will pay millions of dollars to resolve allegations that they falsely billed the state’s Medicaid program, MassHealth. The home health company is Altranais Home Care LLC, located in Lowell. Massachusetts Attorney General Maura Healey announced Friday that… Read More »Home Health Provider to Pay $3.1M to Resolve Improper Billing Allegations
In recent weeks, the possible overturning of the Affordable Care Act (ACA) in court and the upcoming election have focused attention on the issue of protections for people with pre-existing conditions. While the focus has been on the ACA’s private insurance protections, Medicaid also plays… Read More »Medicaid Covers People with Pre-Existing Conditions, Too
This data note looks at national and state-by-state Medicaid and CHIP preliminary enrollment data through June 2020, as states were still in the early stages of experiencing the health and economic effects of the coronavirus pandemic. After declines in enrollment from 2017 through 2019, preliminary… Read More »Analysis of Recent National Trends in Medicaid and CHIP Enrollment
Proposed change to Medicaid line extension definition ignores importance of critical improvements in treatments
In comments recently submitted to the administration, PhRMA raised concerns with a number of changes included in the Centers for Medicare & Medicaid Services (CMS) Medicaid proposed rule. Today, we’re diving deeper into CMS’s proposal to vastly expand the types of medicines that would fall… Read More »Proposed change to Medicaid line extension definition ignores importance of critical improvements in treatments
U.S. Supreme Court decisions shape health policy in important ways. The nomination of Judge Amy Coney Barrett, if confirmed, is expected to establish a solid 6:3 conservative majority that could affect case outcomes in several areas. This issue brief considers the potential implications of a… Read More »A Reconfigured U.S. Supreme Court: Implications for Health Policy
What You Should Know: – Innovaccer unveils new risk adjustment solution to help providers better segment their population to refine the risk scoring process and improve coding accuracy and efficiency, thereby improving performance on risk-based contracts. – The solution utilizes Artificial Intelligence (AI) and Natural… Read More »Innovaccer Unveils Risk Adjustment Solution For Improved Coding Accuracy
The Affordable Care Act, facing its first test during a deep recession, is providing a refuge for some — but by no means all — people who have lost health coverage as the economy has been battered by the coronavirus pandemic. New studies, from both… Read More »Refuge in the Storm? ACA’s Role as Safety Net Is Tested by COVID Recession
What’s the Latest on Prescription Drug Proposals from the Trump Administration, Congress, and the Biden Campaign?
This slideshow explains the similarities and differences among major proposals to lower prescription drug costs introduced by the Trump Administration, members of Congress, and the Biden campaign.
This side-by-side comparison examines President Trump’s record and former Vice President Biden’s positions across a wide range of key health issues, including the response to the pandemic, the Affordable Care Act marketplace, Medicaid, Medicare, drug prices, reproductive health, mental health and opioids, immigration and health… Read More »Health Care and the 2020 Presidential Election
Victor Siclovan, Director of Medicaid Transformation Project at AVIA Living through a pandemic is stressful and anxiety-inducing. Stay-at-home measures are compounding this stress, resulting in social isolation and unprecedented economic hardship, including mass layoffs and loss of health coverage. Fully understanding the impact of these… Read More »Digital Behavioral Health: Addressing The COVID-19 Behavioral Health Crisis
DENVER — D.j. Mattern had her Type 1 diabetes under control until COVID’s economic upheaval cost her husband his hotel maintenance job and their health coverage. The 42-year-old Denver woman suddenly faced insulin’s exorbitant list price — anywhere from $125 to $450 per vial —… Read More »Not Pandemic-Proof: Insulin Copay Caps Fall Short, Fueling Underground Exchanges
What You Should Know: – Molina Healthcare acquires New York-based Medicaid managed care organization Affinity Health Plan for $330M in cash serving members in New York City, Westchester, Orange, Nassau, Suffolk, and Rockland counties. – As of August 31, 2020, Affinity served approximately 284,000 Medicaid… Read More »Molina Healthcare Acquires Affinity Health Plan for $380M
What You Should Know: – NovuHealth and Revel merge to bring together NovuHealth’s personalized healthcare loyalty programs with Revel’s applied behavioral research and health action technologies. – Together, Revel and NovuHealth work with more than 50 healthcare organizations, including seven of the top 10 largest… Read More »Revel, NovuHealth Merge to Create Largest Healthcare Member Engagement Platform
Andy Aroditis, CEO, NextGate The COVID-19 pandemic is not just a medical crisis. Since the highly contagious disease hit American shores in early 2020, the virus has dramatically changed all sectors of society, negatively impacting everything from food supply chains and sporting events to the… Read More »Accounting for the Social Determinants of Health During the COVID-19 Pandemic
Molina announced it will acquire the assets of Affinity Health Plan, a New York-based Medicaid managed care organization. It’s one of several Medicaid MCO purchases the insurer has announced this year.
Finding previously unidentified insurance coverage can feel a little like a game of hide and seek. Patients may not always be aware of their insurance or eligibility for Medicare and Medicaid, and, in an effort to both improve the patient financial experience and simultaneously improve… Read More »Finding unidentified coverage without a Social Security Number (SSN)
Earlier this month, the Congressional Budget Office (CBO) gave an update to its federal budget projections between 2020 and 2030. As expected, things look grim for 2020. CBO projects a federal budget deficit of $3.3 trillion in 2020, more than triple the shortfall recorded in… Read More »CBO: COVID-19’s impact on the federal budget
While all eyes and ears are focused on COVID-19 and beating this pandemic, the administration has pursued harmful policy changes that we can’t let slip under the radar. In two back-to-back regulatory actions in recent months, the administration has taken steps to make it harder… Read More »Recent administration actions undermine patient assistance programs
As the COVID-19 pandemic continues, states have taken a number of Medicaid policy actions to address the impact on seniors and people with disabilities, many of whom rely on long-term services and supports (LTSS) to meet daily needs and are at increased risk of adverse… Read More »State Actions to Sustain Medicaid Long-Term Services and Supports During COVID-19
This data note looks at national and state-by-state Medicaid and CHIP preliminary enrollment data through May 2020, as states were still in the early stages of experiencing the health and economic effects of the coronavirus pandemic. Data show that after declines in enrollment from December… Read More »Analysis of Recent National Trends in Medicaid and CHIP Enrollment
The Trump administration’s latest effort to use COVID-19 rapid tests — touted by one senior official as a “turning point” in arresting the coronavirus’s spread within nursing homes — is running into roadblocks likely to limit how widely they’ll be used. Federal officials are distributing… Read More »Trump Is Sending Fast, Cheap COVID Tests to Nursing Homes — But There’s a Hitch
In a near-empty arena on the river in his hometown of Wilmington, Delaware, former Vice President Joe Biden accepted the Democratic nomination for president, promising hope over fear, fairness over privilege, love over hate. And, he said, “Facts over fiction.” Let’s see about that. Our… Read More »Democratic Convention, Night 4: ‘Facts Over Fiction’ in Biden’s Speech
Manufacturer cost-sharing assistance programs can save chronically ill patients hundreds to thousands of dollars annually
A recent analysis by IQVIA shows that chronically ill patients who used manufacturer cost-sharing assistance in 2019 saved hundreds to thousands of dollars on their out-of-pocket costs. IQVIA found that nearly one-third of commercially insured patients taking brand anticoagulants, diabetes or oncology medicines used manufacturer… Read More »Manufacturer cost-sharing assistance programs can save chronically ill patients hundreds to thousands of dollars annually
Food Insecurity and Health: Addressing Food Needs for Medicaid Enrollees as Part of COVID-19 Response Efforts
This brief provides an overview of food insecurity among Medicaid enrollees during the COVID-19 pandemic, examines participation in federal nutrition assistance programs by Medicaid enrollees, and identifies potential actions to address food insecurity among Medicaid enrollees as needs grow in response to the COVID-19 pandemic.
Addus HomeCare Corporation (Nasdaq: ADUS) is rebounding from coronavirus-related disruption in its personal care and home health segments, company leadership noted Tuesday during a second-quarter earnings call. But the Frisco, Texas-based company also acknowledged there are still significant challenges on the horizon. “Addus had a… Read More »Addus COO: Recruiting Has Been ‘a Little Bit of a Struggle’ During COVID-19
Irv Lichtenwald, President & CEO of Medsphere Systems Corporation In the late 1940s, the United Kingdom was busily reassembling country and what remained of the empire in the aftermath of World War II. Among many revelations, the war had convinced Britain’s leaders of the need… Read More »COVID-19 Underscores Why Certain Aspects of the American Healthcare System Should Change Forever
Can’t see the audio player? Click here to listen on SoundCloud. President Donald Trump keeps promising to unveil a comprehensive plan to replace the Affordable Care Act, but it keeps not appearing. However, this week he did order an expansion of telehealth for Medicare beneficiaries and… Read More »KHN’s ‘What the Health?’: Still Waiting for That Trump Health Plan
These state fact sheets offer a snapshot of the administration and delivery of Medicaid pharmacy benefits in each state.
Despite strong opposition from Republicans and rural voters, Missouri on Tuesday joined 37 states and the District of Columbia in expanding its Medicaid program. Voters in Missouri approved creating a state constitutional amendment that will open Medicaid eligibility to include healthy adults starting July 1,… Read More »Missouri Voters Approve Medicaid Expansion Despite GOP Resistance
The COVID-19 pandemic has led to renewed interest among policymakers, the media, residents, and their families in nursing home regulation and oversight, as residents and staff are at increased risk of infection due to the highly transmissible nature of the coronavirus, the congregate nature of… Read More »Key Questions About Nursing Home Regulation and Oversight in the Wake of COVID-19
Telehealth has quickly transformed the healthcare industry. Rather than scheduling an appointment, waiting up to a few weeks, and going to a doctor’s office or another healthcare facility, we can now access many types of care from the convenience of our smartphones. However, telehealth has… Read More »Telehealth and COVID-19: Overcoming New Challenges for Providers and Payers
As states and cities shatter their old coronavirus records due to the current summer resurgence, health care officials and policymakers are once again shining a spotlight on high-risk populations, which include older adults in the community, individuals living in long-term care facilities and the immunocompromised.… Read More »‘Family CNA Model’ for Pediatric Home Health Patients Gaining Momentum Amid COVID-19
ST. LOUIS — Haley Organ thought she had everything figured out. After graduating from a small private college just outside Boston, she earned her master’s degree, entered the workforce and eventually landed a corporate job here as a data analyst. Life seemed to be going… Read More »Missourians to Vote on Medicaid Expansion as Crisis Leaves Millions Without Insurance
When Will Lightbourne looked at the statistics behind California’s coronavirus cases, the disparities were “blindingly clear”: Blacks and Latinos are dying at higher rates than most other Californians. As of Monday, Latinos account for 45.6% of coronavirus deaths in a state where they make up… Read More »Medi-Cal Agency’s New Head Wants to Tackle Disparities and Racism
As reported by Kaiser Health News: Reversing a three-year decline, the number of people covered by Medicaid nationwide rose markedly this spring as the impact of the recession caused by the outbreak of COVID-19 began to take hold.Yet, the growth in participation in the state-federal… Read More »Medicaid enrollment on the rise
What You Should Know: – W2O announced today the acquisition of Discern Health, a leading healthcare consultancy based in Washington, DC, and Baltimore, to strengthen its strategic capabilities in assisting clients with critical healthcare policy trends and value-based reimbursement models. – Discern Health brings experts with… Read More »W2O Acquires Discern Health to Strengthen Value-Based Care Capabilities
Steve Alvarez started feeling sick around Father’s Day weekend this year. His symptoms started as mild, but developed into a fever, chills and shortness of breath he couldn’t shake. “Just when I started to get to feeling better and I would have a couple of… Read More »In Texas, More People Are Losing Their Health Insurance as COVID Cases Climb
In a speech this month, former Vice President Joe Biden, the presumptive Democratic presidential nominee, offered the third installment of a four-part economic plan being rolled out in advance of the Democratic National Convention in August. This set of proposals focused on caregivers — whether for… Read More »Biden Is Right. Pay for Home Health Workers Is Paltry.
Reversing a three-year decline, the number of people covered by Medicaid nationwide rose markedly this spring as the impact of the recession caused by the outbreak of COVID-19 began to take hold. Yet, the growth in participation in the state-federal health insurance program for low-income… Read More »The COVID-19 Downturn Triggers Jump in Medicaid Enrollment
Jay Desai, CEO & Co-Founder, PatientPing As COVID-19 continues to impact the country, providers across the continuum face new challenges delivering care and ensuring safety for their patients and themselves. During this period, sharing real-time information about patients’ care encounters across provider types and care… Read More »How ADT-Based E-Notifications Can Enable Better Safety for COVID-19 Patients
This data note looks at national and state-by-state Medicaid and CHIP enrollment data through April 2020, as states were beginning to experience the health and economic effects of the coronavirus pandemic.
The predictions were dire: Coronavirus lockdowns would put millions of Americans out of work, stripping them of their health insurance and pushing them into Medicaid, the health insurance program for low-income people. In California, Gov. Gavin Newsom’s administration projected that the pandemic would force about… Read More »Medicaid Mystery: Millions of Enrollees Haven’t Materialized in California
Temporary Enhanced Federal Medicaid Funding Can Soften the Economic Blow of the COVID-19 Pandemic on States, but is Unlikely to Fully Offset State Revenue Declines or Forestall Budget Shortfalls
The temporary boost in federal Medicaid funding enacted as part of the Families First Coronavirus Response Act (FFCRA) will soften the economic blow of COVID-19 on states, but is unlikely to fully offset state revenue declines or forestall budget shortfalls stemming from the pandemic, finds… Read More »Temporary Enhanced Federal Medicaid Funding Can Soften the Economic Blow of the COVID-19 Pandemic on States, but is Unlikely to Fully Offset State Revenue Declines or Forestall Budget Shortfalls
This brief examines how much fiscal relief states can expect from the increase in the Medicaid FMAP under FFCRA under different assumptions about the duration of the relief, how the FMAP increase provides broad fiscal relief to states and the factors that affect how much… Read More »How Much Fiscal Relief Can States Expect From the Temporary Increase in the Medicaid FMAP?
Senior care — an increasingly important topic that’s too often overlooked on the campaign trail — is back in the spotlight. And maybe this time it will have some staying power. Presumptive Democratic presidential nominee Joe Biden has floated a sweeping new 10-year plan that… Read More »Biden Announces $775B Plan to Boost the Caregiver Economy, Support In-Home Care Providers
LTC cases in hotspot states are increasing at 4x the rate as LTC cases in non-hotspot states. Media has largely focused on the share of cases attributed to a younger population. However, increased cases in long-term care facilities are cause for concern, given that nearly… Read More »Rising Cases in Long-term Care Facilities Are Cause for Concern
Molina will acquire Passport Health Plan’s Medicaid and dual-eligible business for $20 million. The Kentucky-based company is a long-standing provider of Medicaid managed care plans, but lost a bid with the state earlier this year.
This data note looks at state Medicaid managed care enrollment data from March 2019 and March 2020 as well as managed care enrollment data obtained from state websites for April and May 2020, to help begin to assess the impact of the COVID-19 pandemic and… Read More »Data Note: Growth in Medicaid MCO Enrollment during the COVID-19 Pandemic
Many states are anticipating significantly higher Medicaid enrollment numbers for the remainder of 2020 and beyond as out-of-work Americans look to replace lost employer-sponsored health insurance. To prepare for this likely surge, Medicaid plans must take proactive steps to curtail inappropriate medical costs without sacrificing… Read More »Five critical areas of focus for Medicaid plans amid COVID-19
Researchers at the Urban Institute found that up to 10 million people could lose their job-based insurance due to Covid-19 by the end of the year.
This Medicaid waiver tracker page aggregates tracking information on pending and approved Section 1115 Medicaid waivers. It includes resources such as an overview map and figure, detailed waiver topic tables, and explanatory briefs.
What You Should Know: – 8 in 10 consumers said COVID-19 made telehealth “an indispensable part of the healthcare system, according to a new study commissioned by Change Healthcare. – 2020 Change Healthcare – Harris Poll Consumer Experience Index reveals 65% said they plan to… Read More »8 in 10 Consumers Stated COVID-19 Made Telehealth “Indispensable” in Healthcare Delivery
A network of community health centers in northern California quickly built out telehealth tools, mapping services and other technologies to respond to Covid-19. Leaders with two organizations shared how they did it.
The COVID-19 pandemic and resulting economic downturn are taking a toll on mental health for many Americans, with large shares of the public saying that related worry and stress is having a negative effect on their mental health. A new KFF analysis and series of… Read More »New State Fact Sheets Highlight Key Data About Mental Health and Substance Use Needs and Capacity
We Are in Store for the Greatest Change to Our Healthcare System Since the Affordable Care Act. Here’s Why.
By LOGAN CHO The COVID-19 pandemic has been harsher and lasted longer than many of us would have predicted. While our media has been inundated with updates on death tolls and economic depression, there has been little conversation of healthcare beyond the era of COVID-19.… Read More »We Are in Store for the Greatest Change to Our Healthcare System Since the Affordable Care Act. Here’s Why.
As a teenager, Paulina Castle struggled for years with suicidal thoughts. When her mental health was at its most fragile, she would isolate herself, spending days in her room alone. “That’s the exact thing that makes you feel significantly worse,” the 26-year-old Denver woman said.… Read More »Colorado, Like Other States, Trims Health Programs Amid Health Crisis
What You Should Know – Doctor On Demand raises $75M in Series D funding led by General Atlantic to expand comprehensive virtual care. – Doctor On Demand is seeing record usage this year – up 139% – for COVID-19 screenings, routine health issues, chronic conditions and behavioral health. San Francisco, CA-based Doctor… Read More »Doctor On Demand Raises $75M to Expand Comprehensive Virtual Care Platform
In response to COVID-19, all 50 states + DC are using emergency waivers and other authorities to make changes to their Medicaid programs. Check out details of these Medicaid emergency authorities on our tracker.
This page displays an interactive map of the current status of state decisions on the Affordable Care Act’s Medicaid expansion. Additional Medicaid expansion resources are listed (with links) below the map.